Psych revision session Flashcards
What do you need to consider in management
Bio
Psycho
Social
Illusion
Misperception of a real stimuli
Hallucination
Perception in the absense of an external stimulus
2nd person hallucinations- who gets them
Depression
Personality disorder
3rd person hallucinations- who gets them
Schizophrenia (first rank symptom)
Visual hallucination who gets them
Lewy body dementia/ organic
Over valued idea
Belief sustained beyond logic/reason but held with less rigidity than a delusion
Delusion
False belief that is firmly maintained in spite of invontrovertible evidence to the contrary
Delusional perception
Delusional belief resulting from a real perception (1st rank symptom)
What do you call first rank symptoms
Schneiderian first rank symptoms
Thought insertion
Thoughts have been exerted by an external agency (1st rank)
Thought withdrawal
Thoughts have been stolen by an external agency (1st rank)
Thought broadcast
Thoughts are being broadcast so that they can be heard by others (1st rank)
Thought echo
Form of auditory hallucination where the person hears their thoughts spoken aloud (1st rank)
Thought block
Sudden interruption in the train of throught, leaving a blank
Concrete thinking
Lack of abstract thinking (asd/psychosis)
Loosening of association
Lack of logical association between thoughts leads to incoherent speech
Circumstantiality
Talking at great length around the subject but returns to the topic
Perseveration
Repetition of a word (usually associated with organic/ frontal lobe/ wernickes encephalopathy- vit b1)
Tangential
Does not return to the topic
Confabulation
Giving a false account to fill a memory gap (not deliberate)- korsakov psychosis
Somatic passivitiy
Delusional belief that patient is a passive recipient of bodily sensation imposed from outside forces (1st rank)
Made acts, feelings and drives
The experience being carried out by the patient is considered as alien/ imposed (1st rank)
Psychomotor retardation
Slowing of thoughts and movements
Stupor
Loss of activity with no response to stimuli, may mark a progression of motor retardation
Catatonia
Significantly excited or inhibited motor activity (with waxy flexibility or posturing)
Flight of ideas
Rapid skipping from one thought to a distantly related ideas
Neologisms
Use of novel or made up words
Pressure of speech
Rapid rate of delivery may be associated with rhymes and puns
Poverty of speech
Reduced amount
Anhedonia
Reduced enjoyment from normally pleasurable activity
Flattening of affect
Reduced range of emotional expression
Incongruity of affect
Mismatch between emotional expression and content
Obsession
an unwanted recurrent thought (experienced as intrusive)
Compulsion
An irresistible urge to behave in a certain way
Belle indifference
An apparent lack of concern at symptoms/ disability
Depersonalisation
Thoughts and feelings do not seem to belong to oneself
Derealisation
Feeling as if you are looking at yourself from the outside
Sterotypy
Persistent repetition of a movement, not goal directed (problem is the nature of movement)
Mannerism
Repetition of a seemingly purposeful gesture of language or behaviour (problem is frequency)
Differential diagnosis of psychosis
Schizophrenia, drug induced psychosis, depressive psychosis, organic pscyhosis
Who would treat first episode of psychosis
Early intervention service
1st episode psychosis team
Home treatment team
Capgras syndrome
Imposter syndrome
TV is referring to him
Delusional of reference
Postive psychosis symtoms
Delusions
Disordered thought and speech
Hallucinations
Respond well to medication
Negative psychosis symptoms
Flat affect Poverty of speech Lack of motivation Poor ability to function Respond less well to medications
Residual schizophrenia
Chronic negative symptoms
Simple schizophrenia
Insidious and progressive negative symptoms with no history of psychotic symptoms
1st rank symptoms
Auditory hallucinations (3rd)
Passivity experiences
Thought alienation
Delusional perception
Acute and tranisent psychosis
Short lived
2 week long, 3 month recovery
no treatment
Persistent delusional disorder
Long standing delusion only without hallucination
Old people
Food, smells, contamination
Sensory problems
Schizoaffective disorder
Both affective and schizophrenic symptoms are present together
Pueperal psychosis
Within days or weeks of childbirth
Organic psychosis
Related to overt brain disorder/ delirium Epilepsy Brain tumours Lewy body Parkinsons
Psychosis bio management
Antipsychotics (clozapine if treatment resistant)
Psychosis psycho management
Family therapy
CBT
Psychosis social management
Family intervention, carer support
Employment, activity, education
Support with engagement, benefits, PSI
Clozapine
Agranulocytosis, monitor WBC
Toxic megacolon
Constipation
What type of bipolar is caused by just one manic episode
Bipolar type 1
Describe bipolar
Increased speed of talk Irritable Grandiose beliefs Increased sex drive and energy Reduced need for sleep Inappropriate eurphoria Risky behaviours Functional impairment
Hypomania
Bipolar type 2
Lesser degree of mania that does not affect functioning to the same degree
Symptoms of hypomania
Elevation of mood for days Talkativeness Overfamiliarity Increased sexual energy Decreased sleep No psychotic symptoms
Bipolar diagnosis
Significant disturbance
Atleast 2 episodes
Some element of recovery between episodes
Depressive episodes longer as people get older
Bipolar bio management
Mood stabilisers - lithium
Carbazapine
Sodium valproate
Lithium SE
Thyroid dysfunction
Tremor
Kidney dysfunction
Narrow therapeutic index
Sodium valproate
Changes hair
not in pregnant
Carbamazepine
Rash
Neutropenia
Lamotragine
Rash
Stephen johnson syndrome
Olanzapine
Metabolic
Extrapyrimidal side effects
Psycho treatment of bipolar
cbt
relapse
psychoeducation
Bipolar social treatment
Family and carer support
education
Does a diagnosis or drug automaticly automatically stop you driving (not epilepsy)
No
Bipolar and driving
Patient should inform the DVLA. They will then do function tests.
Core symptoms of depression
Low mood
Annhedonia
Reduced energy
Mild depression
2 core and 2 other
Moderate defintion
2 core and 3-4 others
Baby blues
Transient condition, 2 weeks. Lability of mood, tearful, anxiety and depressive symptoms. Normal
Post natal depresion
Depressive disoder in weeks/ momths post partum
Normal treatment
Puerperal psychosis
Within days or weeks of delivery Often admission to mother and baby unit Psych emergency Probable hormonal aetiology High subsequent risk
Depression management bio
SSRI, then with TCA then and ajuvant ECT
Depression psycho management
CBT
Group work/ self help
Psychoeducation
Depression social management
Family and carer support
Employment/ activity/ education
Support with engagement and benefits
Mild depression treatment
Watchful waiting
IAPT
Hypnotics
Benzodiazepines
Z drugs
Melatonin
Name benzos
Diazepam, temazepam, lorazepam, chlordiazepoxide
Anxiolytics
First line- IAPT
Second line- Sertalline, pregabalin
SSRI SE
Abdominal, suicidality, sexual dysfunction, safe in OD
Tricyclics SE
Sedation, anticholinergic, cardic arrythmias
SNRIs
Suicidality, serotonin syndrome, sexual dysfunction
Mirtazepine SE
Sedation and weight gain
MAOI SE
Hypertensive crises with cheese and red wine
Extrapyramidal side effects
Dystonia
Occulogyric crisis
tardive dyskinesias
EPS side effects treatment
procyclodine IM
Clozapine SE
Weight gain, neutropenia, good for treatment resistance, and movement disorders
Metabolic side effects
DM, weight gain, lipids, nms
1st generation antipsychotics se
EPS
2nd generation antipsychotics se
Metabolic
Mood stabilisers
Lithium
Mood stabilisers
ADHD Managment
Methylphenidate
Family therapy and training
SE methylphenidate
Appetite suppression, psychosis, misuse
ADHD other meds
Atomoxetine (liver, suicide)
What type of drug is mirtazepine
Tetracyclic
Mood disorder psych treatment
Counselling
Psychoeducation
CBT
Personality disorder therapy
Dialectic behavioural therapy
OCD therapy
Exposure and response prevention
PTSD therapy
Eye movement densensitisation and reprocessing
Social interventions
Benefits Care package, social prescribing Cultural support Help with meaningful activity Safeguarding Street triage
Emotionally unstable personality disorder
Unstable relationships Instable mood Feeling of emptiness Impulsivity Disturbed self image
Alcohol withdrawal treatment
Detox
Delerium tremens treamtent
Detox, B1 and supportive
Peurperal psychosis treatment
MHA and antipsychotic
Alternative to doing a 5.2
Get a nurse to do a 5.4
What does anankastic mean
Obsessive
What is section 2
Detention in hospital for assessment of your mental health and potentially get treatment
Lasts up to 28 days
What is section 5 4
Nurse holding power, 6 hours
Needs to be followed by MHA
What is section 136
Police removal from public place designated place of safety for MHA assessment
What is section 125
Police removal from home to designated place of safety for MHA assessment- needs magistrate
Who for section 3
AMP
Sectional 12 approved doctor
another doctor
Conditions needed for section 3
Mental health disorder
Nature or degree to warrant detention in hospital
Risk to self, others or health
Who could release you from a section 3
Responsible officer for that patient
Nearest relative
Hospital management hearing
Psychotic symtoms
1st, 2nd, 3rd hallucinations, delusional beliefs, thought disorders
3rd person command auditory hallucinations
Voices telling you to do things
Belief that things dont exist/ are dying
Nihilistic delusion
Belief that seperate events refer to them
Delusion of reference
Delusion that they are amazing
Grandiose delusion
Spouse is imposter delusion
Capgas syndrome
Person in disguise delusion
Fregoli syndrome
Person is lying delusion
Delusional misperception
Paranoid schizophrenia
Auditory/ visual hallucinations and delusions (persecutory and or grandiose). No thought disorder or flattened affect
Hebephrenia schizophrenia
Thought disorder and flat affect present together
What are passivity experiences
Made actions/ feelings- delusion of control
Types of thought alienation
Thought insertion, thought withdrawal, thought broadcast
Manic symptoms
Increased energy and sex drive Decreased need for sleep Increased talking speed and racing thoughts Grandiose beliefs/ inflated self esteem Psychotic beliefs Inappropriate elation or euphoria Irritability High risk activities Functional impairment